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GACA الحييه العامه للطيران المدين General Authority of Civil Aviation [Non-Text] TRAINING CENTER EVALUATOR/EXAMINER AUTHORIZATION ISSUANCE/RENEWAL APPLICATION FORM (AIRPLANE/HELICOPTER) TC Evaluator/Examiner authorization valid for 12 calendar months <table><tr><td colspan="4">FOR TRAINING CENTER USE ONLY</td></tr><tr><td colspan="4">1. Training Center Details</td></tr><tr><td>Training Center Name</td><td colspan="3"></td></tr><tr><td>Address</td><td colspan="3"></td></tr><tr><td>Aircraft (A/H) Type</td><td colspan="3"></td></tr><tr><td>Training Post Holder (Director of Training)</td><td>Name</td><td>Email</td><td>Phone No.</td></tr></table> <table><tr><td colspan="2">2. Application Details</td></tr><tr><td>Application for Training Center Evaluator/Examiner Authorization</td><td>☐ Issuance ☐ Renewal</td></tr><tr><td>Aircraft (A/H) type details</td><td>Aircraft (A/H) variant details</td></tr></table> <table><tr><td colspan="3">3. TC Evaluator/Examiner (Applicant) Details</td></tr><tr><td colspan="3">Applicant Name</td></tr><tr><td>Date &Place of Birth</td><td>License Number</td><td></td></tr><tr><td>License Type</td><td>State of license issue</td><td></td></tr><tr><td>Aircraft (A/H) type & variant</td><td>License Expiry Date(if applicable)</td><td></td></tr><tr><td>Type Rating Expiry Date(12 calendar months expiry)</td><td>TC Instructor authorization expiry date (for renewal)</td><td></td></tr></table> hereby declare that the information given in this form is true & correct <table><tr><td>Applicant Signature</td><td></td></tr></table> 4. Training Center Evaluator/Synthetic Flight Examiner Authorization Issuance Pre-Requisites Requirements <table><tr><td colspan="2">Seq.</td><td>GACA PART 142 Requirements</td><td>YES</td><td>NO</td></tr><tr><td>1</td><td colspan="4">Eligibility - To be eligible for consideration as a TCE, candidates must first</td></tr><tr><td>a</td><td colspan="2">Hold or have held at least a Commercial Pilot License (CPL) (A/H), as appropriate, to act as pilot in command (PIC) for the specific Aircraft.</td><td>□</td><td>□</td></tr><tr><td>b</td><td colspan="2">Hold or have held at least Airline Transport Pilot License (ATPL) (A/H), to act as pilot in command (PIC) of the specific Aircraft for ATPL checks;</td><td>□</td><td>□</td></tr><tr><td>c</td><td colspan="2">Hold a valid type rating on the applicable airplane/Helicopter type for which Evaluator/Examiner is authorized to conduct Checks/Skill tests or Proficiency checks;</td><td>□</td><td>□</td></tr><tr><td>d</td><td colspan="2">Hold a valid Training Center Instructor in accordance with GACAR Part 142, Subpart C requirements;</td><td>□</td><td>□</td></tr><tr><td>e</td><td colspan="2">Be currently assigned as an instructor at the employing Approved Training Center;</td><td>□</td><td>□</td></tr><tr><td>f</td><td colspan="2">Be qualified in each specific curriculum and the associated flight training equipment for which TCE privileges are requested.</td><td>□</td><td>□</td></tr><tr><td>g</td><td colspan="2">Must be in Compliance with the requirements established in GACAR-142, EBOOK V14 (Chapter 10), GACAR PART-183 and any applicable GACA requirements for the issuance or renewal of the relevant Evaluator/Examiner certificate/authorization;</td><td>□</td><td>□</td></tr><tr><td>h</td><td colspan="2">For Individuals that meet the above eligibility criteria will be evaluated on the following criteria before proceeding with formal training:</td><td>□</td><td>□</td></tr><tr><td>1</td><td colspan="2">Have a history of cooperation with the GACA, and a good record as an airman regarding accidents, incidents. The GACA must verify the airman information through the GACA's recordkeeping system(s) before scheduling any training or qualification observations. The airman's information will be retained in the TCE's file.</td><td>□</td><td>□</td></tr><tr><td>2</td><td colspan="2">Have a reputation for integrity and dependability within the industry and the community.</td><td>□</td><td>□</td></tr><tr><td>3</td><td colspan="2">Candidates requesting authorization to conduct evaluations in an aircraft while acting as a required crew member must have logged at least 100 hours as PIC in the M/M/S of aircraft except when approved as initial Cadre on newly certificated aircraft types or newly acquired aircraft for the employing training center.</td><td>□</td><td>□</td></tr><tr><td>1</td><td colspan="2">Is able to read, write, and speak and understand in the English language according to GACAR §</td><td>□</td><td>□</td></tr></table> GACA-AVSES-OPS-F030 Rev: 3, Date: 15 Jun 25 Page 1 of 5 GACA ال necesita العامه للطيران المدني General Authority of Civil Aviation [Non-Text] TRAINING CENTER EVALUATOR/EXAMINER AUTHORIZATION ISSUANCE/RENEWAL APPLICATION FORM (AIRPLANE/HELICOPTER) <table><tr><td></td><td>61.51;</td><td></td><td></td></tr><tr><td>j</td><td>A training center may not allow an evaluator to conduct an evaluation in an aircraft in flight while occupying a required crew member seat unless that evaluator holds at least a valid Class 1 medical certificate.</td><td>□</td><td>□</td></tr></table> 5. Evaluator/Examiner Acceptance/Authorization Issuance Requirements <table><tr><td>Seq.</td><td>GACA PART 142 Requirements</td><td>YES</td><td>NO</td></tr><tr><td>1</td><td colspan="3">TCE Training and Qualification</td></tr><tr><td>a</td><td>Must meet the GACAR-Part 142 and 183 requirements to be designated by the President:</td><td>□</td><td>□</td></tr><tr><td>b</td><td>Must be in compliance with GACAR § 142.55, 142.57, and 142.59;</td><td>□</td><td>□</td></tr><tr><td rowspan="5">c</td><td>Satisfactorily completes prior to designation, and except as provided in GACAR 142 (142.61) paragraph (b), every 12-month period following initial designation, a curriculum that includes the following:</td><td>□</td><td>□</td></tr><tr><td>(i) Evaluator duties, functions, and responsibilities;</td><td>□</td><td>□</td></tr><tr><td>(ii) Methods, procedures, and techniques for conducting required tests and checks;</td><td>□</td><td>□</td></tr><tr><td>(iii) Evaluation of pilot performance; and</td><td>□</td><td>□</td></tr><tr><td>(iv) Management of unsatisfactory tests and subsequent corrective action; and</td><td>□</td><td>□</td></tr><tr><td>d</td><td>Satisfactorily passes a written test and annual proficiency check in an approved FFS or aircraft in which the evaluator will be evaluating if evaluating in qualified and approved flight training equipment.</td><td>□</td><td>□</td></tr><tr><td>e</td><td>An evaluator who satisfactorily completes a curriculum required by (142.61 paragraph (a)) in the month before or after the month in which it is due is considered to have taken it in the month which it was due for the purpose of computing when the next training is due.</td><td>□</td><td>□</td></tr><tr><td>f</td><td>The President may give credit for the requirements of (142.61 paragraph (a)(3)) to an evaluator who has satisfactorily completed an evaluator training course for a certificate holder operating under GACAR Part 121 or 135 if the President finds such a course equivalent to the requirements of GACAR PART-142 (142.61 paragraph (a)(3)).</td><td>□</td><td>□</td></tr><tr><td>g</td><td>TCE applicants must satisfactorily complete the training required by GACAR Part 142. The training must include, as a minimum, the items under GACAR §142.61(a)(3).</td><td>□</td><td>□</td></tr><tr><td>h</td><td>Candidates will be observed and evaluated conducting each portion of a practical test or proficiency check as appropriate. This evaluation will include an observation of the applicant conducting a complete oral, simulator, and (if appropriate) aircraft flight-testing modules as well as associated briefings and debriefings appropriate for the authorization(s) requested. The qualification evaluation(s) referenced above must be conducted in accordance with a core curriculum approved for the training center employment and appropriate for the evaluation authority being sought.</td><td>□</td><td>□</td></tr><tr><td>i</td><td>The applicant must also demonstrate the proper completion of the airman certification and/or qualification paperwork required by the employing center as well as appropriate GACA documentation and reporting.</td><td>□</td><td>□</td></tr><tr><td>j</td><td>Must complete the initial and recurrent training requirements in accordance with GACAR PART 142, EBOOK V14 and other applicable GACARs requirements</td><td>□</td><td>□</td></tr><tr><td>k</td><td>Pilot TCEs may accomplish their recency of experience requirements in an approved Level C or D Full Flight Simulator (FFS).</td><td>□</td><td>□</td></tr><tr><td>1.1</td><td colspan="3">TCE Proficiency Checks</td></tr><tr><td>a</td><td>TCEs must remain qualified as an instructor in all curriculums/courses for which he holds evaluation authority. Therefore, TCEs must meet all instructor training and testing/checking requirements in order to remain authorized as a TCE for a particular curriculum/course.</td><td>□</td><td>□</td></tr><tr><td>b</td><td>GACAR § 142.61(a)(4) requires a TCE to satisfactorily pass an annual proficiency check in the flight training equipment in which he is authorized to conduct evaluations. This proficiency check must be conducted in a simulator or aircraft that represents the M/M/S of aircraft in which the TCE will be conducting evaluations.</td><td>□</td><td>□</td></tr><tr><td>c</td><td>In addition to the point (2(b)) above, if authorized to evaluate in the aircraft due to the limitations of the FSTD for 100 percent testing and checking, the TCE must accomplish an annual proficiency check in the aircraft on the maneuvers that cannot be accomplished in the simulator.</td><td>□</td><td>□</td></tr><tr><td>d</td><td>Completed Training Center Evaluator/Examiner Initial acceptance requirements, training, awareness about the applicable administrative procedures, contents of Training and Procedures Manual(s), Quality System, SMS (if applicable) as well as related documents, forms and records in accordance with Training Center and Procedures Operations Manual</td><td>□</td><td>□</td></tr><tr><td>e</td><td>Demonstrates to GACA an adequate level of knowledge of the applicable GACA rules and regulations to be able to exercise Evaluator/Examiner privileges in accordance with GACA requirements</td><td>□</td><td>□</td></tr></table> GACA-AVSES-OPS-F030 Rev: 3, Date: 15 Jun 25 Page 2 of 5 GACA العربيه اعلان للطيران المدني General Authority of Civil Aviation TRAINING CENTER EVALUATOR/EXAMINER AUTHORIZATION ISSUANCE/RENEWAL APPLICATION FORM (AIRPLANE/HELICOPTER) <table><tr><td>f</td><td>Completed an Examiner standardization arrangement with GACA Aviation Safety Inspector (ASI) or Qualified TCE Designated by GACA under GACA supervision.</td><td>□</td><td>□</td></tr><tr><td>g</td><td>Pass Evaluator/Examiner approval/acceptance evaluation (briefing, conducting Check/test, assessment, de- briefing & recording /documentation) by GACA ASI or Qualified Designated Evaluator/Examiner under GACA ASI Supervision.</td><td>□</td><td>□</td></tr></table> 6. Evaluator/Examiner Acceptance Authorization Renewal Requirements <table><tr><td>Seq.</td><td>GACA PART 142 Requirements</td><td>YES</td><td>NO</td></tr><tr><td>1</td><td>TCE Recurrent Training</td><td></td><td></td></tr><tr><td>a</td><td>TCE recurrent training must be completed within the previous 12 months, prior to the TCE designation being renewed.</td><td>□</td><td>□</td></tr><tr><td>b</td><td>Each TCE must satisfactorily complete annual training in those subject areas required for initial qualification and changes to GACA regulations and policy.</td><td>□</td><td>□</td></tr><tr><td>c</td><td>Due dates for the renewal of TCE authorizations must be considered. Completion of the annual training and/or checking in the calendar month before or the calendar month after the due month is considered to have been completed in the month it was due.</td><td>□</td><td>□</td></tr><tr><td>2</td><td colspan="3">Recurrent TCE Proficiency Check(s)</td></tr><tr><td>a</td><td>Each TCE must satisfactorily accomplish a written test and proficiency check in a full flight simulator/FTD/aircraft in which evaluations will be given.</td><td>□</td><td>□</td></tr><tr><td>b</td><td>TCE must comply with the annual instructor qualification requirements, including a proficiency check in each curriculum, and specific flight training equipment in which instruction will be given. The proficiency check required by GACAR §§ 142.59 and 142.61 may be combined provided the content of the check meets the proficiency check requirements for a TCE and is appropriate to the M/M/S of aircraft represented by the device in which evaluations have been authorized.</td><td>□</td><td>□</td></tr><tr><td>c</td><td>TCEs must maintain their qualifications as instructors in order to retain their evaluator's authorization as a TCE. Each required proficiency check must have been accomplished within the 12 months prior to the expiration date of the TCE designation.</td><td>□</td><td>□</td></tr><tr><td>d</td><td>If approved by the GACA, the TCE proficiency check required by GACAR § 142.61 may be conducted by a TCE qualified and current in the specific curriculum and flight training equipment.</td><td>□</td><td>□</td></tr><tr><td>e</td><td>Following point (1(d)) above, approval to permit a TCE to conduct these checks may be granted on a one-time basis or other reasonable time period that the GACA deems appropriate. Such approval must be made in writing and not to be included in the TCE's COD Approvals to conduct the subject evaluations and will have an expiration date no later than TCE's current COD.</td><td>□</td><td>□</td></tr><tr><td>3</td><td>Observation and Evaluation</td><td></td><td></td></tr><tr><td>a</td><td>Ninety days before the expiration date of a TCE's designation, an Inspector will be scheduled to observe the TCE conduct a complete practical test for at least one of the authorizations held.</td><td>□</td><td>□</td></tr><tr><td>b</td><td>The purpose of this observation is to evaluate the TCE's ability to administer a test or check as an evaluator and to complete the appropriate documentation. The TCE's aircraft specific knowledge and flight training equipment proficiency is evaluated during the annual instructor proficiency check for each curriculum.</td><td>□</td><td>□</td></tr><tr><td>c</td><td>If, due to unforeseen circumstances, it is not practical to observe a TCE with certification authority conducting a certification event, a proficiency check administered under GACAR Part 61 or 121, or a combined competency/proficiency check under GACAR Part 135 may be substituted at the discretion of the GACA.</td><td>□</td><td>□</td></tr><tr><td></td><td>NOTE: The GACA should only allow a competency or proficiency check in lieu of a certification event for renewal of the TCE's certification if it can be determined that the previous observation was made during the accomplishment of an actual certification event.</td><td>□</td><td>□</td></tr><tr><td>d</td><td>If a TCE who is holding certification authority is unable to be observed conducting an actual certification event due to the center's lack of workload, the principal inspector (PI) shall evaluate the need for the TCE to hold certification authority. Inability to observe a TCE conduct a practical test for an actual certification event is justification for a reduction of the TCE's authority or termination of the TCE's designation.</td><td>□</td><td>□</td></tr><tr><td>e</td><td>For TCEs with authorizations limited to proficiency checks only, a complete proficiency check will be required for renewal.</td><td>□</td><td>□</td></tr><tr><td>f</td><td>If the TCE is qualified in more than one type of aircraft, alternating annual observation of an evaluation should be planned.</td><td>□</td><td>□</td></tr></table> 7. Director of Training (Post Holder) Compliance statement and Recommendation I hereby certify that the applicant is a current and approved Training Center Instructor (TCI/SFI) on ( GACA-AVSES-OPS-F030 Rev: 3, Date: 15 Jun 25 Page 3 of 5 GACA الحييه العامه للطيران المدني General Authority of Civil Aviation [Non-Text] TRAINING CENTER EVALUATOR/EXAMINER AUTHORIZATION ISSUANCE/RENEWAL APPLICATION FORM (AIRPLANE/HELICOPTER) <table><tr><td colspan="2">) Airplane/Helicopter Type Rating and at ( ) Training Center. The applicant meets the applicable GACARs requirements (GACARs (142,183,61) GACARs EBOOK (V3, V4, V14) and all other applicable GACARs requirements for Training Center Evaluator/Examiner authorization issuance/renewal.</td></tr><tr><td>Name</td><td>Signature Date</td></tr><tr><td></td><td></td></tr></table> FOR GACA USE ONLY <table><tr><td colspan="3">1. Evaluator/Examiner Designation</td></tr><tr><td colspan="3">The undersigned GACA Training Centers Manager authorizes Capt. (Designee Evaluator/Examiner) to conduct the Evaluator/Examiner Authorization Practical check/test☐ Initial☐ Renewal Observation Evaluation</td></tr><tr><td>Manger Name</td><td>Signature</td><td>Date</td></tr><tr><td></td><td></td><td></td></tr></table> <table><tr><td colspan="4">2. Evaluator/Examiner Recommendation(Evaluator/Examiner notified by GACA in (Evaluator/Examiner Designation))</td></tr><tr><td>Training Center Name</td><td></td><td>Date</td><td></td></tr><tr><td>FSTD Type & number</td><td></td><td>Aircraft Type (A/H)</td><td></td></tr><tr><td colspan="4">Total flight time</td></tr><tr><td>TCE authorization Check/Test result</td><td colspan="3">□ Satisfactory □ Unsatisfactory</td></tr><tr><td>TCE authorization Renewal Evaluation result</td><td colspan="3">□ Satisfactory □ Unsatisfactory</td></tr><tr><td colspan="4">Examiner recommendations</td></tr><tr><td colspan="2">Evaluator/Examiner Name</td><td>Signature</td><td>Date</td></tr><tr><td colspan="2"></td><td></td><td></td></tr><tr><td colspan="2">ASI or Senior Examiner (Observer Name)</td><td>Signature</td><td>Date</td></tr><tr><td colspan="2"></td><td></td><td></td></tr></table> <table><tr><td colspan="4">3. GACA Recommendation</td></tr><tr><td colspan="2">Evaluator/Examiner authorization (Designation)</td><td>□ Issuance</td><td>□ Renewal</td></tr><tr><td colspan="2">Evaluator/Examiner authorization (Designation) issuance/renewal</td><td>□ Approved</td><td>□ Not Approved</td></tr><tr><td colspan="4">TC Evaluator/Examiner privileges</td></tr><tr><td colspan="4">Evaluator/Examiner privileges (on Aircraft (A/H) Type Rating)</td></tr><tr><td>TCE Authorization/Designation expiry date</td><td></td><td>TC Instructor Expiry Date</td><td></td></tr><tr><td>Type rating expiry date</td><td></td><td>License expiry date, if applicable</td><td></td></tr><tr><td>Training Center Name</td><td></td><td>(A/H) type Rating & variant</td><td></td></tr><tr><td colspan="4">Remarks</td></tr></table> <table><tr><td>Air Safety Inspector Name</td><td>Signature</td><td>Date</td></tr><tr><td></td><td></td><td></td></tr></table> GACA-AVSES-OPS-F030 Rev: 3, Date: 15 Jun 25 Page 4 of 5 GACA ال necesita للطيران المدني General Authority of Civil Aviation [Non-Text] TRAINING CENTER EVALUATOR/EXAMINER AUTHORIZATION ISSUANCE/RENEWAL APPLICATION FORM (AIRPLANE/HELICOPTER) SUPPORTING DOCUMENTS - Cover Letter from the Training Center concerned, if required, for Examiner/Evaluator authorization/Designation issuance/renewal. • This application form. - Certificate/Letter of satisfactory completion of Training Center Evaluator/Examiner approved training programme (curriculum) in accordance with GACAR 142.61 (a) (3); and • Certificate/evidence of satisfactory passes a written test in accordance with GACAR 142.61 (a) (4) • Copy of applicant pilot License (CPL/ATPL). • Copy of related logbook pages or any other equivalent evidence, if required • Copy of class 1 Medical, for Aircraft checks. • Copy of Valid Training Center Instructor Authorization/Certificate. - Copy of valid Aircraft Type Rating Skill Test/Proficiency check of the Aircraft type rating in which the Evaluator/Examiner will be authorized to conduct Checks/Skill tests or Proficiency checks. - Copy of the expired or previous valid Examiner/Evaluator authorization (GACA designation) (for renewal only) - After conducting of Examiner/Evaluator authorization issuance check/test or examiner renewal evaluation: - Evaluator/Examiner authorization Competency check/test report. ○ Evaluator/Examiner Standardization (required to be signed by applicant for the initial designation). GACA-AVSES-OPS-F030 Rev: 3, Date: 15 Jun 25 Page 5 of 5